The Strategy Unit, Ipsos MORI, 10 December 2019 (full copy of an email from The Strategy Unit)
Evidence and resources from a range of sources on person-centred care and person-centred measures.
• The Strategy Unit
• What is Person-centred Care
• Person-centred measures
• Frameworks and guidance
• Implementation
• Research
• Other useful resources
A guide to implemnting person-centred intelligence and an offer of support
In partnership with Ipsos MORI the Strategy Unit has developed a guide describing approaches to implementing person-centred intelligence (PCI) with an offer of support and a range of case studies. It is supported by a series of guides and other resources on a dedicated microsite.
What is Person-centred care?
A Narrative for Person-Centred Coordinated Care (National Voices, 2013)
This narrative describes what good quality integrated care looks like, from the point of view of anyone who needs access to multiple services over time. Created with the help of Think Local Act Personal (TLAP), and working with service users, carers, charities, commissioners and professionals, it was adopted as a national definition for integrated care by all the system leading bodies in England, including the Department of Health in a national 'Shared commitment' document.
Person-centred care made simple (Health Foundation 2014)
This guide seeks to provide a quick overview of person-centred care. It is written for anyone interested in health and health care, including health care professionals and those who use the NHS.
What is person-centred care and why is it important? (Health Innovation Network South London, 2016)
This brief document provides an overview of what person-centred care is and why it is important.
Current person-centred care policy
NHS Long Term Plan (NHS England, 2019) - recognises the need for a ‘fundamental shift in how we work alongside patients and individuals to deliver more person-centred care, recognising the importance of ‘what matters to someone’ is not just ‘what’s the matter with someone’.
Universal Personalised Care: Implementing the Comprehensive Mode1 (NHS England, 2019) - sets out NHS England's plan to achieve personalised care benefiting up to 2.5 million by 2023/24.
Person-centred intelligence
Measuring what really matters: Towards a coherent measurement system to support person-centred care (Health Foundation, 2014) - describes the principles of person-centred care and the activities that a person-centred system should undertake in different contexts. The paper also describes the core constituents of person-centredness to demonstrate the steps that could be followed in order to develop a coherent measurement system.
Helping measure person-centred care: A review of evidence about commonly used approaches and tools used to help measure person-centred care (Health Foundation, 2014) - signposts to research about commonly used approaches and tools to help measure person-centred care. A spreadsheet listing 160 of the most commonly researched measurement tools accompanies the review.
Measuring patient experience (Health Foundation, 2013) - provides an accessible overview of the range of methods that have been used to measure patient experience, in order to help practitioners, planners and researchers consider the best approaches for their own local improvement initiatives.
‘What matters to patients’? Developing the evidence base for measuring and improving patient experience (King's College London / The King's Fund, 2011) - had three aims: to establish what matters to patients, (particularly in the non-acute sector); to review what NHS organisations in England currently measure in relation to what matters to patients; and provides examples of NHS organisations in England that are using information and insights into patient experience to improve the quality and productivity of health care services.
Outcomes for mental health services: What really matters? (The King’s Fund, 2019) - examines the pursuit of outcomes by mental health services, highlighting how frameworks for measuring outcomes are often too narrowly focused on clinical outcomes.
Person-centred measures for integrated care
Developing measures of people’s self-reported experiences of integrated care (Picker Institute, 2013) - follows the, ‘Options appraisal on the measurement of people’s experiences of integrated care’ report, with a set of measures which can be inserted into existing national collections to measure components of integrated care.
Developing an integration scorecard: A model for understanding and measuring progress towards health and social care integration (SCIE, 2017) - an overarching framework for what good health and social care integration looks like in the form on a logic model. A set of metrics for measuring progress towards this is proposed. (N.B. free MySCIE registration required)
Integrated care and support Pioneers: Indicators for measuring the quality of integrated care Final report (Policy Innovation Research Unit, 2014) - provides information on performance indicators using available health and social care data sources, to monitor the progress of integrated care. The indicators were primarily developed for the 'Integrated Pioneers' sites, who also provided feedback on the indicators.
Trusted measures: analytical resources for integrated care (Nuffield Trust, 2018) - toolkit signposts analytical approaches to integrated care that have been developed at the Nuffield Trust based on what can be measured using routine data, including staff and patient experience of integration.
Compendiums of person-centred measures
Measures for Person Centred Coordinated Care - a full database of unselected/unsorted P3C measures that is fully searchable and filterable, as well as a “shortlists” database containing selected example measures in various categories of person centred coordinated care (p3c).
Patient-Reported Outcomes Measurement Information System (PROMIS) - aims to compile a core set of questions to assess the most common or salient dimensions of patient–relevant outcomes for the widest possible range of chronic disorders and diseases. The database can be filtered to find relevant measures.
Care Coordination Atlas (CCA): List of 80 measures - measures have been mapped to care coordination domains for three care coordination perspectives using measure numbers and profiles designed to provide more detailed information on the measure’s purpose, format and data source, perspective, validation and testing, links to outcomes, applications, and key sources.
National Patient and Staff Surveys - from patients, services users and NHS staff about the care that they receive or provide. This web page links to survey results published by both NHS England, partner organisations and CQC.
Patient-Reported Outcomes Measurement Group - has established a number of important resources focusing on Patient-Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs).
Helping measure person-centred care - evidence review links to an accompanying spreadsheet that provides details of 160 of the most commonly researched person centred measurement tools. The list was created based on screening more than 200,000 studies published between 2000 and 2013. The spreadsheet allows users to search according to the type of tool, who it targets and the main contexts it has been tested in.
International Consortium for Health Outcomes Measurement (ICHOM) - aims “to transform health care systems worldwide by measuring and reporting patient outcomes in a standardised way.” ICHOM organises global teams of physician leaders, outcomes researchers and patient advocates to define Standard Sets of outcomes per medical condition.
Frameworks of person-centred care
Integrated commissioning for better outcomes (ICBO): A commissioning framework (Local Government Association, 2018) - covers four areas: building the foundations; taking a person-centred, place-based and outcomes-focused approach; shaping provision to support people, places and populations; and continuously raising the ambition.
Framework on integrated, people-centred health services (WHO, 2016) - sets out a vision of a future in which all people have access to health services that are provided in a way that are coordinated around their needs, respects their preferences, and are safe, effective, timely, affordable, and of acceptable quality.
Commissioning guidance
Personalised Care: Finance, Commissioning and Contracting Handbook (NHS England, 2019) - guide aims to provide finance, commissioning and contracting staff with the information required to implement personalised care locally. It will enable staff to understand what the expansion of the programme means for their areas of work; what specialist support is available to facilitate the expansion; and what the impact may be on current processes and local contracting arrangements.
Involving people in their own health and care (NHS England, 2017) - aims to help Clinical Commissioning Groups (CCGs) to involve people in their own health and care in a meaningful way. It demonstrates the importance of involving people, their carers and families, to improve individuals’ health and wellbeing outcomes and the efficiency and effectiveness of health services. It also explains how CCGs and NHS England can meet their legal duties.
Commissioning person centred end of life care A toolkit for health and social care (NHS England, 2016) - contains a range of practical resources to support those involved in commissioning for person centred end of life care.
Six principles for engaging people and communities: Putting them into practice (National Voices, 2016) - sets out principles of good person-centred, community-focused health and care and offers case studies and key questions to help local leaders put them into practice. This includes a supplement on definitions, evaluation and measurement, with information and suggestions to help organisations and planners to understand and measure impact.
How to Use Metrics, Measures &C Insights to Commission Person Centred Coordinated Care (PenCLAHRC, 2017) - provides practical guidance on how and why to use metrics, measures and insights to commission, evaluate and improve processes and outcomes in Person Centred Coordinated Care (P3C) for people living with long-term conditions, multiple long term conditions (i.e. multi-morbidity) or at the end of their life.
PFCC: Patient and Family-Centred Care toolkit (The Point of Care Foundation) - provides a step-by-step guide to improving processes of care and staff–patient interactions. It offers a simple way for organisations to show their commitment to patients’ experience while also motivating the staff who deliver that care.
Clinical guidance
Social prescribing and community-based support Summary guide (NHS England, 2019) - is part of the NHS Long-Term Plan’s commitment to make personalised care ‘business as usual’ across the health and care system. This guide is aimed at people and organisations leading local implementation of social prescribing.
Shared Decision Making: Summary guide (NHS England, 2019) - is intended for people leading local implementation of shared decision making.
Module 1: PAM: implementation - quick guide (NHS England, 2018) - aims to provide practical and operational support to organisations looking to implement the PAM. It focuses on why patient activation is important and what organisations need to consider before implementation.
Personalised care and support planning handbook: The journey to person-centred care (NHS England, 2016) - sets out what personalised care and support planning is, and how to deliver it.
Patient experience in adult NHS services (NICE, 2019) - quality standard covering improving the quality of the patient experience for people who use adult NHS services.
Community engagement: improving health and wellbeing and reducing health inequalities (NICE, 2016) - covers community engagement approaches to reduce health inequalities, ensure health and wellbeing initiatives are effective and help local authorities and health bodies meet their statutory obligations.
Person-Centred Approaches: A core skills education and training framework (Skills for Health, 2017) - provides a description of behaviours, knowledge and skills to put a person-centred approach into practice.
Implementation
NHS England
Innovative models of general practice (The Kings Fund, 2018) - sets out five attributes that underpin general practice including person-centred, holistic care.
Supporting people to manage their health: An introduction to patient activation (The Kings Fund,2014) - draws on evidence from the US and UK to describe PAM a patient reported measure used to gauge patient activation.
Delivering better services for people with long-term conditions: Building the house of care (The Kings Fund, 2013) - describes a co-ordinated service delivery model – the ‘house of care’ – that aims to deliver proactive, holistic and patient-centred care for people with long-term conditions. It incorporates learning from a number of sites in England that are working to achieve these goals, and makes recommendations on how key stakeholders can work together to improve care for people with long-term conditions.
Practical guides to measuring impact
How to... understand and measure impact (NHS England, 2015) - aims to help local areas to understand and measure the impact of their efforts to integrate services across the provision of health and care. It is intended to be of practical use to members of Health and Wellbeing Boards (HWBs) including: councils, clinical commissioning groups (CCGs), local Healthwatch and voluntary sector members, representatives of NHS England who sit on HWBs, and additional non-statutory members.
The Good Indicators Guide: Understanding how to use and choose indicators (NHS Institute for Innovation and Improvement and The Association of Public Health Observatories, 2017) - is intended to be a short, practical resource for anyone in any health system who is responsible for using indicators to monitor and improve performance, systems or outcomes.
Research: UK
Person-centred care in 2017: Evidence from service users (National Voices, 2017) - attempts to create a snapshot of the extent of person-centred care in the English health and care system, based on how people report their experience of treatment, care and support.
Is the NHS becoming more person-centred? (Health Foundation, 2015) - examines how the NHS in England has performed over this parliament in relation to indicators that reflect person-centred care. It considers a range of measures including: dignity, respect and compassion; patient involvement in decisions; support for self-management and care planning.
People in control of their own health and care: The state of involvement (The Kings Fund, 2014) - explores why there has been a lack of progress towards fully involving people in their own health and care despite person centred care being a policy goal of politicians and senior policy-makers in health for at least 20 years.
Independent evaluation of the feasibility of using the Patient Activation Measure in the NHS in England: Final Report (University of Leicester, 2017) - evaluators worked alongside a ‘learning set’ of five Clinical Commissioning Groups and one disease registry as they experimented with using the PAM in different ways and at different levels of scale, across a range of approaches for improving care and supporting self-management
Research: International
The state of play in person-centred care: a pragmatic review of how person-centred care is defined, applied and measured, featuring selected key contributors and case studies across the field (Health Foundation, 2015) - provides a comprehensive picture of the state of play in research, implementation and measurement of person-centred care, looking at the future direction and gap analysis of each of these fields, and highlighting key work, barriers and opportunities to progress.
Use of patient-reported outcome and experience measures in patient care and policy (KCE, 2018) - explains what PROMs and PREMs are, why they can be relevant to patients, clinicians and policy makers and what the barriers and prerequisites are in case of implementation. The report includes international examples and lessons learned.
Person-centred care in Europe: a cross-country comparison of health system performance, strategies and structures (Picker Institute, 2016) - provides an overview of health systems’ performance and strategies in person-centred care across Europe. It focuses on five European countries as exemplars and highlights general learning from them. In each country, the briefing looks at both policy and practice in areas linked to person-centred care, including patient choice, patient information, patient involvement and public satisfaction with the health system.
Other useful resources
Person-centred care resource centre (BMJ and Health Foundation) - aims to help healthcare professionals implement a more person-centred healthcare service, where people are supported to more effectively manage and make informed decisions about their own health and care.
Realising the Value: external resources (NHS England, Nesta and Health Foundation - focuses on five areas of person-centred and community-based practice: Self-management education; Peer support; Health coaching; Group activities that promote health and well-being; and Asset-based approaches in a health and well-being context.
Evidence for person-centred care (National Voices) - is a collection of evidence summaries and case studies showing the impact of person-centred care.
The Royal College of General Practitioners Person-Centred Care - collection of resources on person-centred care.
The Royal Collge of Physicians policy: person-centred care - collection of resources on person-centred care.
Quality and Outcomes of person-centred Care Policy Research Unit (QORU) publications - aim to improve the quality of health and social care of people with long-term conditions (LTCs), developing and using high quality evidence about need, quality and outcomes of person-centred care.
Person-Centred Coordinated Care (P3C) - provides a list of associated papers from the authors of the Measures for Person Centred Coordinated Care and associated guide.
